Healthcare Provider Details

I. General information

NPI: 1750653564
Provider Name (Legal Business Name): CHRISTIE B SMITH PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 MERCANTILE PL STE 101
FORT MILL SC
29715-2005
US

IV. Provider business mailing address

441 MERCANTILE PL STE 101
FORT MILL SC
29715-2005
US

V. Phone/Fax

Practice location:
  • Phone: 803-220-4207
  • Fax:
Mailing address:
  • Phone: 803-220-4207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11442
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP21780
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501015817
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: